2005-2006 Collegiate Chapter Officers List

Form Due: March 3, 2006
Instructions
  • Complete all of the information on this form.
  • Make a hard copy of the completed form.
  • Keep one (1) copy on file for ERP.
  • Click the Send button, to Send Form to the National Office.
  • Click the Clear button, to Clear the contents of the form.
Region:

CHAPTER & SCHOOL INFORMATION
Chapter:

Chapter E-Mail Address:

Chapter Mailing Address:

Date of Election (mm/dd/yyyy):

School Opens (Fall) (mm/dd/yyyy):

Date of Installation (mm/dd/yyyy):

OFFICER INFORMATION
PRESIDENT:

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

VICE PRESIDENT #1:

    Vice President Position (if applicable e.g., Programming):

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

VICE PRESIDENT #2 (if applicable):

    Vice President Position (if applicable e.g., Programming):

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

VICE PRESIDENT #3 (if applicable):

    Vice President Position (if applicable e.g., Programming):

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

CORRESPONDING SECRETARY:

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

RECORDING SECRETARY:

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

TREASURER:

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

PLEDGE TRAINER:

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

HISTORIAN:

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

ADDITIONAL OFFICER #1 (if applicable):

    Officer Title (e.g., Parliamentarian, ERP):

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

ADDITIONAL OFFICER #2 (if applicable):

    Officer Title (e.g., Parliamentarian, ERP):

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

    Home Address:

    Home City, State Zip:

    Home Phone:

    Home E-Mail:

ADVISOR #1:

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

ADVISOR #2 (if applicable):

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

ADVISOR #3 (if applicable):

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

Dean of College/School of Business:

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

Dean or Associate Dean of Students:

    School Address:

    School City, State Zip:

    School Phone:

    School E-Mail:

Comments, Explanations, Additional Information:

Before Proceeding
  • Have you completed and verified all of the information on this form?
  • Have you printed a hard copy for your file?
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